Disparities in SARS-CoV-2 exposure: evidence from a citywide seroprevalence study in Holyoke, MA

Principal Investigator: Louise C. Ivers MD MPH DTM&H

Authors: Wilfredo R. Matias*, Isabel R. Fulcher*, Sara M. Sauer, Cody P. Nolan, Yodeline Guillaume, Jack Zhu, Francisco J. Molano, Elizabeth Uceta, Shannon Collins, Damien M. Slater, Vanessa M. Sanchez, Serina Moheed, Jason B. Harris, Richelle C. Charles, Ryan M. Paxton, Sean F. Gonsalves, Molly F. Franke, Louise C. Ivers
Lay Abstract

A “seroprevalence study” tests a person’s blood sample for the presence of antibodies. It gives a better estimate of the number of people that have been infected with SARS-CoV-2, the virus that causes COVID-19. We conducted a seroprevalence study in Holyoke, Massachusetts, to estimate how many people were previously infected with SARS-CoV-2, identify high-risk groups, and guide public health responses to the pandemic.

We invited 2,000 randomly selected addresses between 11/5/2020 – 12/31/2020. Participants completed questionnaires and gave a blood sample for antibody testing. We enrolled 280 households including 472 individuals. 328 underwent antibody testing. The seroprevalence of SARS-CoV-2 IgG antibodies was 13.1% for the entire city. It was 16.1% among Hispanic individuals compared to 9.4% among non- Hispanic white individuals. Spanish speaking households (21.9%) had a higher seroprevalence compared

 

to English speaking households (10.2%), as did individuals living in high- (14.4%) compared to low- vulnerability areas (8.2%).

 

SARS-CoV-2 antibody seroprevalence in Holyoke was only 13.1% during the second surge in 2020, meaning a large part of the population remained at risk. Hispanic individuals were at high risk of prior infection. SARS-CoV-2 exposure disparities require proactive public health interventions to ensure at-risk communities have appropriate access to vaccines, testing, and treatment.

Scientific Abstract

We conducted a SARS-CoV-2 seroprevalence study in Holyoke, Massachusetts, US to estimate the seroprevalence of antibodies, risk factors for seropositivity and inform public health responses to COVID- 19.

We invited 2,000 randomly sampled addresses between 11/5/2020 – 12/31/2020 to complete questionnaires and provide dried blood spots for SARS-CoV-2 antibody testing. We calculated IgG antibody seroprevalence estimates using a Bayesian procedure that incorporates uncertainty in test sensitivity and specificity.

 

We enrolled 280 households including 472 individuals. 328 underwent antibody testing. Citywide seroprevalence of SARS-CoV-2 IgG was 13.1% (95%CI 6.9-22.3). Seroprevalence was 16.1% (95%CI 6.2-31.8) among individuals identifying as Hispanic compared to 9.4% (95%CI 4.6-16.4) among those identifying as non-Hispanic white. Seroprevalence was higher among Spanish speaking households (21.9%; 95% CI 8.3-43.9) compared to English speaking households (10.2%; 95% CI 5.2-18.0) and among individuals living in high- (14.4%; 95% CI 7.1-25.5) compared to low-vulnerability areas (8.2%; 95% CI 3.1-16.9).

 

SARS-CoV-2 seroprevalence of IgG antibodies in Holyoke was only 13.1% during the second surge in 2020 highlighting the need for expanding vaccination. Individuals identifying as Hispanic were at high risk of prior infection. Disparities in SARS-CoV-2 exposure require proactive public health interventions to ensure at-risk communities have appropriate access to vaccines, testing, and timely treatment.

Clinical Implications
We estimated a SARS-CoV-2 seroprevalence of 13.1% during the 2nd COVID-19 surge in Holyoke, MA. Hispanic individuals, Spanish-speaking households and people in high-vulnerability areas were at high risk, highlighting the need for proactive public health interventions to support these groups.

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